" A Tale of Two Cities": Anticoagulation Management in Patients with Atrial Fibrillation and Prosthetic Valves in the Era of Direct Oral Anticoagulants

Medicina (Kaunas). 2019 Aug 4;55(8):437. doi: 10.3390/medicina55080437.

Abstract

Valvular heart disease and atrial fibrillation often coexist. Oral vitamin K antagonists have represented the main anticoagulation management for antithrombotic prevention in this setting for decades. Novel direct oral anticoagulants (DOACs) are a new class of drugs and currently, due to their well-established efficacy and security, they represent the main therapeutic option in non-valvular atrial fibrillation. Some new evidences are exploring the role of DOACs in patients with valvular atrial fibrillation (mechanical and biological prosthetic valves). In this review we explore the data available in the medical literature to establish the actual role of DOACs in patients with valvular heart disease and atrial fibrillation.

Keywords: atrial fibrillation; novel oral anticoagulants; prosthetic valve replacement.

Publication types

  • Review

MeSH terms

  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / physiopathology
  • Factor Xa Inhibitors / pharmacology
  • Factor Xa Inhibitors / therapeutic use
  • Heart Valve Diseases / drug therapy*
  • Heart Valve Diseases / physiopathology
  • Humans
  • Risk Factors

Substances

  • Anticoagulants
  • Factor Xa Inhibitors